Many articles about diabetes appear daily, many of them very interesting. The intent here is to make some of these available for others who may not see them or have bypassed them. I will try to comment briefly on those I have grouped or on an individual article. This is not guaranteed to be a daily post, but I hope that this will give you ideas for your own research or blog posts. Please talk to your doctor about medical problems.

03 September 2013

Hospitals – Money Is the Only Driver

Hospital leaders are either enlightened or not. If you look hard
enough, you can find many enlightened leaders that have embraced
hospital capacity management. These leaders view the emergency
department (ED) as the front door to the hospital. These leaders
understand that the ED interacts with more patients, family, friends,
and providers than any other area of the hospital. This means that
the ED is an enormous generator of capacity management, not just
affecting the ED, but the entire hospital. Therefore these leaders
move resources, implement new processes, such as well-run and staffed
observation units, to address the management of the capacity issues
directly affecting patients waiting for a hospital bed.

Dr. Robbin Dick is a little over the top, but he has a right in
many cases and does spell out some of the shortcomings found in many
hospitals. It has a lot to do with who has what position in the
hospital pecking order. Some hospitals only operate this way and the
higher up the ladder a particular doctor, the more control he/she
wields and some wield this control for every advantage to them.
Others care and share duties and see that procedures are within the
needs of the hospital.

Often it is the surgeons and cardiologists that are high on the
hospital ladder and they demand that their needs and lifestyle are
fostered at the expense of everyone else.

I was surprised by Dr. Dick's statement in his blog, but in
discussing this with now three different hospital administrators, he
is right with one exception. The exception hospital is run by Nuns
to this day, and they do not hesitate to fire any doctor that thinks
he/she has a lock on the hospital ladder and start demanding certain
things happen for their benefit. When I talked to the head of the
hospital recently, she apologized for not responding to me earlier,
but employee matters were taking more time than they should. I know
this person and asked her point blank if she was referring to the two
surgeons no longer on the hospital staff. She laughed and told me I
had been reading the local paper, which was true. Many hospitals
have retained religious ownership, but are run by other people
trained for this. This is a rare hospital.

This hospital will admit that the ED is the driving force and they
do make way for the patients arriving this way, but at the same time,
she admitted that they space out surgeries when possible to make room
for those arriving through the ED. She also stated that when
surgeons feel that they have special hours, that is when their wheels
fall off and out the door they go. In the last ten years she did say
that have had 10 different surgeons. She maintains that they are all
told that they have no special privileges and when they feel they do,
to pack up and leave. They have four surgeons all working different
hours on a rotating basis. Plus, she said they have eliminated four
other surgeons and cooperate with another hospital in transferring
specific patients to them.

This administrator admits that it would be great if they could be
providing patient centered care, but this does not pay the bills.
She does say that maybe this will happen in the future, but the
current healthcare law will not permit this although some are
claiming it is possible. She says if they do this, they will lose
money unless they can divide the hospital and have a high profit side
and a very low loss side.

The other point she made to me was something Dr. Dick rails
against. She said that when doctors become too big for their
britches, this means that the hospital will lose money. She admits
that doctor centered care was a money loser and this she would not
permit.

About Me

I am enjoying life, despite diabetes type 2. I am retired and enjoying the time I have for writing and photography. I was diagnosed with type 2 on Oct 2003, on oral meds for 4 months and they were doing nothing to really improve my daily readings. By cutting my carbohydrates I received the most improvement, but still not enough. Then I requested insulin, even though I did not like the thought of needles. That brought about the biggest change and A1c's in the lower 6's and upper 5's. Now I am working at maintaining them under 6.0 and hopefully nearer 5.5.